Meet Dr. Kay Moua, advanced diabetes management specialist for Tulalip’s health clinic

By Micheal Rios, Tulalip News

Native communities and diabetes. The two have been linked since colonization forcibly removed tribes from their ancestral lands and traditional food sources. Ever since it’s been a never ending struggle to battle one of the most challenging health problems of the 21st century. According to the World Health Organization, each year an estimated 1.8 million deaths are directly caused by diabetes, while another 2.2 million deaths are attributed to high blood glucose.

It’s no question that diabetes is a nationwide health problem, but for Native people its life altering effects are felt at a much higher rate. Native communities have the highest diabetes prevalence of all ethnic groups in the United States. Nearly 1 out of 6 Native citizens has diabetes presently, and the Centers for Disease Control predicts that 1 in 2 Native children born since 2000 will have type 2 diabetes in their lifetime. 

Fortunately, Tulalip is excited to announce a vital new resource in its fight against the shared enemy. Dr. Kay Moua has joined the health clinic’s Diabetes Care and Prevention Program. An advanced diabetes management specialist, she brings a treasure trove of experience and cutting edge knowledge. She is well regarded for her expertise in the latest techniques and most effective practices for managing and preventing diabetes.

Dr. Kay was gracious enough to be interviewed by syeceb staff in order to introduce herself, her medical background, and what she hopes to accomplish in Tulalip. 

SYS: You have a unique cultural background. Can you tell us about it?

I was born in Laos, and my ethnicity is Hmong. My family migrated to a refugee camp in Thailand after the Vietnam War and came to the Unites when I was 11-years-old. I started learning English (e.g. the alphabet, colors, numbers) in 7th grade.

My husband and I have been married for 30 years. We have 4 children, 3 boys and 1 girl. We are family-oriented people and love to host. My husband is the oldest of seven siblings, so we’re always surrounded with family and friends. My in-laws live on the same property, which is common for us to have multigenerational living in the same house. My mother-in-law is a Shaman, so we still perform traditional rituals and practices.  

SYS: Please describe your educational journey to become Doctor Kay. 

I’ve worked in the medical field since graduating High School. My first job was in a family practice where I started as a receptionist, then later trained in back office work, which included billing and rooming patients. I attended a community college while working full-time. After completing my AA degree in Medical Office, I continued school in the pursuit of a nursing degree.

Once I graduated with my Associate Degree in Nursing and earned my license, I went to work as a Registered Nurse (RN) at Providence hospital in Everett. Seeing so many people come into the hospital with poor diabetes control motivated me to pursue my Nurse Practitioner license to help people living with diabetes. After attending graduate school, where I received my Master’s Degree in Nursing (MSN) and Advanced Registered Nurse Practitioner (ARNP) license, I joined the Endocrinology team at the Everett Clinic to care for patients with diabetes. 

Even though I enjoyed my work very much, I knew that I need to get back to school to achieve my personal goal of having a doctoral degree. With hard work and dedication, I graduated with a Doctor of Nursing Practice (DNP) degree in 2015. I continued to take extra classes and trainings and was able to pass the National Board Certified-Advanced Diabetes Management (BC-ADM) certification the following year.

SYS: What motivated you to join the Tulalip Health Clinic and practice medicine for the Tulalip people?

Native Americans are one of the highest risk groups for the development of diabetes. I was surprised to find out that in the history of the Tulalip Health Clinic an Endocrinologist or someone like myself has not been available for the people of Tulalip without a referral to an outside facility. I am pleased to be one of the first contracted providers to manage patients utilizing devices like CGM and insulin pumps. These technologies have evolved over time and under my care and direction we will be offering these devices in 2021 to patients who have this interest in advanced diabetes management.

The Tulalip Health Clinic already has a successful Diabetes Care and Prevention Program. I love the fact that the program is able to provide so many activities to teach people about diabetes and keep the community engaged with the clinic. In fact, I’ve never came across another diabetes program that is so unique and able to provide so much for their patients. I want to work with the team to help expanding the diabetes program by offering advanced diabetes care to Tribal members, to ensure that their treatment is up-to-date with most current medications and have the option to use technologies to enhance diabetes management. Tribal members should not have to seek care outside the Reservation for diabetes treatments. 

SYS: You specialize in advanced diabetes management. Can you explain what this means?

As I mentioned earlier, diabetes care has been my main focus from training during Nurse Practitioner school and my doctoral degree school. I’ve worked with patients with diabetes for over ten years. I continue to immerse myself with conferences and continuation education that’s specialized on diabetes to stay up-to-date with current medications and technologies and guidelines. 

I’m an Advanced Registered Nurse Practitioner (ARNP) by trait, with a Doctor of Nursing Practice (DNP) degree and national Board Certified-Advanced Diabetes Management (BC-ADM) specialist. Patients are referred if they need to improve blood sugar control or have interest in insulin pump or continuous glucose monitor. Diabetes treatment is complicated and has to be individualized. I make sure that patients are offered the best and most appropriate treatment options available to the individual. 

I also have extensive experience incorporating technologies such as continuous glucose monitors and insulin pumps to help patient improve diabetes control. Insurance requires additional documentations and special forms for approval. These technologies requires extra training and longer appointment time with patients that may not be feasible for general providers. This is why my service is required. I work with these devices every day and familiar with insurance requirements for quick approval.  

SYS: With your extensive professional experience, what do you consider the biggest challenges to minimizing the diabetes epidemic?

Unfortunately, diabetes prevalence continues to increase every year. There are many contributing factors to this epidemic. I think our current financial economy posts many obstacles in diabetes prevention and treatment. Budget is tight in most households, especially with more and more people losing their job during COVID, leading to even more unhealthy diet and lack of exercise.

We all know the importance of a healthy diet. However, it may not always be feasible when you have a tight budget. Fresh food costs 2-3 times more than process food. People are working longer hours and don’t have time to cook, so they are eating more fast food. Combining processed and high fat foods with eating late at night contribute to weight gain, leading to increased insulin resistance or worsening diabetes control.

Healthy diet and routine exercise are the cornerstone of diabetes prevention and treatment. As people are working longer hours to make ends meet, they don’t have time to do anything else. Exercise is unlikely to be a high priority after a long work day. Lack of exercise increases fatty tissue, which causes insulin resistance and high blood sugar. 

SYS: In your ideal scenario, how will your work positively impact the Tulalip community?

Diabetes management is complex and requires collaboration between the patient, their family members and the healthcare team to achieve best outcomes. As a new provider of the community, it’s important for me to learn the culture and incorporate the Tribal ways of living when making treatment plans. I believe getting to know the people, developing good rapport with patients, and building trust with the community are the key steps to improving diabetes control within the Tulalip community.

My understanding is that some tribal members have been going elsewhere for advanced diabetes care or have not been active in seeking diabetes care. My goal is to provide the most current diabetes treatment options for members living with diabetes right on the reservation. I will need to prove my knowledge and earn the trust of the community in order to draw members back to the Tulalip Health Clinic for diabetes management. 

SYS: A principle of Native culture has always been holistic care (mind, body and spirit). Considering this, what advice or best practices would you suggest to combat diabetes and pre-diabetes?

I’ve always believe in holistic care approach. It is crucial to access and address the individual’s mental and physical health that may impact their ability to maintain diabetes management. Successful diabetes care also requires taking the time to access and get to know the patient, their family, their environment, and cultural practices and incorporating this information into individual treatment plans. We all have different cultural practices and traditional food that should be respected. 

I’m so excited that the Diabetes Care and Prevention team has a garden to showcase and incorporate the Pacific Northwest native plants for natural medicines and herbal remedies. The Diabetes Program garden provides diabetes education and promotes traditional food, healthy eating, and activity. Healthy diet and staying active are important for everyone, but even more crucial for those who have diabetes or prediabetes.

My goal is to be a resource and provide guidance for patients who have diabetes or at risk of developing diabetes through obstacles like diet, exercise, blood sugar checking, or medication management. Uncontrolled diabetes can cause many unforgiving long-term complications. Diabetes can start to cause damage to internal organs in prediabetes state. Therefore, it is important to do everything you can to maintain good blood sugar control if you are considered high risk or as soon as you found out that you have diabetes.

My vision for the Tulalip Diabetes Program is to expand diabetes care to Tribal members with prediabetes. Historical records show that at least 20% of these patients convert to full blown type 2 diabetes yearly. We need to focus our attention on preventing diabetes in order to decrease the diabetes epidemic. I hope that we will be able to offer routine educational group classes on diabetes disease and have activities to promote healthy eating and active living once it’s safe to have group classes again. In the meantime, I encourage everyone to find safe activities to stay active and practice meal portion control.        

SYS: Anything else you’d like to share to our readers?

Special thanks to Roni Leahy (Tulalip Diabetes Program Coordinator) for having the vision to expand the Diabetes Care and Prevention Program and entrusting me with this opportunity. I am grateful for the support from Dale Jones (Diabetes Program Advocate) and Brooke Morrison (Diabetes Program Assistant). I also like to thank the Tulalip Healthcare providers, Dr. Chad Cleven, Dr. Natasha LeVee, Dr. Howard Johnson, Dr. Rhonda Nelson, and Dr. John Okemah for welcoming me to the clinical team. 

It is an honor and privilege to have the opportunity working with the Tulalip Health System. I look forward to learning the Tulalip culture, earning the trust of each patients and the community, and collaborating care with the clinical team to improve the health and quality of life of tribal members suffering from diabetes.

A remarkable achievement! Moderna Vaccine welcomed with open arms in Tulalip

By Micheal Rios, Tulalip News

On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County with a four-day history of cough and subjective fever. He disclosed he returned to Washington only days prior after traveling to visit family in Wuhan, China. After multiple days of examination and a litany of tests, it was revealed that the man was positive with a severe acute respiratory syndrome caused by a novel coronavirus. This was the first confirmed case of COVID-19 in the United States. 

Nearly one year later, the COVID pandemic continues to rage on. According to the Department of Health, there have been 246,000 confirmed cases and 3,482 deaths in Washington State attributed to the virus at the time this article was published. A whopping 91% of those deaths are individuals at least 60-years-old.

On the Tulalip Reservation, those who are 60+ are revered as elders. They are a living history, a source for cultural and spiritual knowledge whose wisdom is irreplaceable. Protecting them from COVID is of utmost importance, which is why the Tulalip Health Clinic was full of hope and excitement on December 23 as the first doses of the much heralded Moderna Vaccine were administered to Tulalip’s most vulnerable. 

“Today is a great day for Tulalip! We have received the COVID-19 vaccine,” marveled Tulalip tribal member and Patient Care Director, Jennie Fryberg. “My hands go up to everyone who comes to our health clinic to get vaccinated and help save lives, save our community, and save our elders. The 2020 year was a tough one for us because we lost some loved ones to the pandemic. I’m getting vaccinated for my parents, so I can protect them and avoid possibly spreading COVID to them. My advice to our community is come and get vaccinated so we can have a much more hopeful 2021.”

After months of battling the pandemic at the reservation’s go-to health care facility, Tulalip’s emergency management team’s latest update states four Tulalip elders have died with COVID-19. Two were in their 70s and two were in their 80s. Their memories live on in the younger generations who carry on their cultural traditions with pride.

In order to protect as many remaining elders and high-risk tribal members, Tulalip’s medical personnel promptly rolled out phase one of COVID vaccinations after receiving 400 initial doses from Moderna. The immediate recipients were Tulalip’s elders, most high-risk citizens, first responders, and frontline healthcare workers. 

“This is an amazing event taking place and I feel so fortunate to play a role in offering protection and hope to such a beautiful community,” said medical assistant Kristina Bartek while filling syringes with the potential lifesaving Moderna Vaccine. “My grandfather is 84-years-old and it scares me to think of what could happen if he gets COVID. I’ll be getting vaccinated to protect him, myself, and anyone I come into contact with.”

History was made as the first administered vaccination went to Tulalip elder Dale Jones. “We are fighting a very dangerous virus and have already lost some of our people because of it,” shared Dale moments after getting vaccinated. “This vaccine means we finally have protection for our people, especially our elders.”

Real life heroes who put their lives on the line every day to keep the community safe were eager to get a literal shot in the arm to ensure they can carry out their duties while preventing COVID exposure to others. 

“This is a big moment for our community and our fire department by ensuring the health and safety of our first responders,” said Fire Chief Ryan Shaughnessy while joining his team in getting vaccinated. “We’re really excited and grateful for the Tulalip Tribes generosity to vaccinate our team. Moving forward, we can fulfill our duties with more confidence knowing we’re vaccinated against this deadly virus.” 

It’s been two weeks since Tulalip received the vaccine and the health clinic has administered 407 vaccinations as of January 4. Phase two of vaccinations is now underway. Tulalip tribal members ages 50+ and who have chronic health conditions may now stop by the clinic for a vaccination visit. 

If you are a Tulalip elder and not yet received the vaccine, please visit the clinic as soon as possible to do so. You do not need to make an appointment nor call.

“The Moderna Vaccine is a remarkable tool that helps us to decrease the spread of COVID and mitigate life threatening concerns associated with COVID,” said Dr. John Okemah, Chief Medical Officer. “Finally having a vaccine available to our people brings about a new sense of hope to our people throughout Indian Country. We’ve been dealing with this global pandemic for close to a year now. By getting vaccinated we, as a community, are now fighting back and doing what we can to protect our loved ones.”

Tulalip Community Health Youth Care Kits

Submitted by Morgan Peterson, Tulalip Community Health Nurse

Mental health is just as important as physical health. During these difficult times of a pandemic, it’s more important than ever to include self-care in our daily lives. At Tulalip Community Health, we want to provide support to youth that are home on quarantine. We hope these items can help pass the time while at home. We all must do our part to stop the spread of COVID and stay home if exposed to COVID-19 or have tested positive for COVID-19.

Q. What is a Youth Care Kit?

A. A youth care kit is put together with the specific interests of youth in mind. They have various items from Legos and dolls to cooking kits, art activities, and journals.

Q. Who is eligible to receive a youth kit?

A. Youth kits are available to households in isolation/quarantine due to having a family member in the home testing positive for COVID-19.

Q. What ages do these kits include?

A. The items are for children 3-18

Q. How can I receive one of these Youth Care Kits?

A. There are a couple of ways to receive a care kit:

  •  When someone is notified of a positive COVID-19 test result, please let the caller know there are children in the home and the ages.
  •  Call Community Health (360) 716-5662 and request a youth care kit. Please leave a message with your name and good number, and someone will call you back.
  • Call Tiffany Robinson from the Community Health Transportation Department (360) 722-1635

Family Wellness Court an alternative, collaborative approach to reunification

By Kalvin Valdillez, Tulalip News

At the start of 2017, the Tulalip Tribal Court implemented a new program to assist addicts on their recovery journey. The Healing to Wellness Court originally drew a bit of skepticism from Tribal membership due to failed experiments with drug courts in the past. However, after tailoring the wellness court to the individual client and incorporating cultural involvement, the program saw success, with a handful of clients completing the program and many addicts who are clean and working hard to maintain their sobriety.

Four years since the announcement of the Healing to Wellness Court, the Tribal Justice department is gearing up to introduce a similar program, but with an emphasis on not only helping their clients live healthy and sober lives, but to reunify families who have been torn apart by the opioid epidemic. Family Wellness Court aims to get the parents clean, help them regain custody of their children and get them out of the court system for good. 

Tulalip Tribal Court Director, Alicia Horne explained, “The Family Wellness Court is very similar to the Healing to Wellness Court. It’s an alternative program to help parents with addiction and it’s an evidence-based program to help parents with addiction sustain sobriety. This is something that is different from your traditional beda?chelh case management. The Family Wellness program has wrap-around, intensive family case management to help the family as a whole, so the parents can maintain stable sobriety.”

Although the Family Wellness Court’s game plan mirrors the Healing to Wellness Court model in many aspects, the court wants to stress that the two programs are completely separate from one another. Family Wellness will work with individuals on their own accord, through either a referral or self-referrals, as the new program is 100% voluntary based and not mandated by the courts. Whereas the Healing to Wellness Court works on criminal cases and their clients could potentially face jail time if they fall out of compliance. Family Wellness Court is a guided program where a team creates an individualized plan for the parent, and since the program is voluntary and does not work on criminal cases, the client does not face jail time if they fall off track.  

“We’re one of the first in the nation to be doing this as a tribe because we want our people to be healthy, happy and successful,” said Family Wellness Court Coordinator, Melissa Johnson. “We want people to understand it’s different than the standard dependency proceeding that parents involved with beda?chelh go through. With more frequent review hearings, in the drug court model, they get a chance to show their progress in real-time. They tend to get their kids back faster in this type of program because of the intensive case management and the added support.”

A team will meet regularly, on a weekly-basis, to discuss the client’s progress or regression. The team then decides on the appropriate action to take, whether that is awarding them with incentives or providing intervention services or resources to help them find their way back to the road of sobriety. 

“We assist parents with medical care if they need it, as well as referrals to housing, helping with job placement, job training, so they can live a healthy and sober life and maintain it on their own,” Melissa stated. “We want to give them the skills, the foundation to maintain that healthy lifestyle once they’re finished with our program. One of our goals is to have fewer CPS and beda?chelh involvement.”

Members of the team include Tulalip tribal court’s Chief Judge Michelle Demmert, Associate Judges Janine B. Van Dusen and Leona Colegrove, as well as a Child Advocate Attorney, Parent Advocate Attorney, beda?chelh Manager (Natasha Fryberg), beda?chelh Social Worker, Substance Use Disorder Counselor, Family Wellness Court Coordinator (Melissa), Recovery Support Specialist, and the Wellness Program Manager. 

Said Melissa, “The team meets weekly and the program is going to last around a year, sometimes it takes longer. It’s based on individual needs because some parents need more support than others. Rather than feeling lost in the system, the participants will gain a sense of continuity and identification with the program. The hearings will allow the judge to provide the support, encouragement and responses as needed. What happens really is the courtroom becomes more of a therapeutic environment versus what it is now. We want them to build trust and a relationship with the judge, so they’re not afraid of interacting with the judge.”

The Tulalip Tribal Court believes that this collaboration between multiple departments, with the same intent of helping someone attain sobriety, is the key to success with drug court clients. Helping them establish relationships with the judges and task force members, the clients are included in the entire process from the moment they accept the help from the Family Wellness Court to the moment they are reunified with their children. 

“I am thrilled that the Tulalip tribal court and community will be able to engage in this holistic child welfare program,” shared Child Advocate Attorney, Chori Folkman. “Studies have shown that this type of collaborative team-based approach results in faster case resolution and more families becoming reunified than a normal child welfare case. The support of beda?chelh will be complimented by all the other team members who will be working hard to support the needs of parents to become healthy and reach their full potential for the children. I think that in the Tulalip system, we can make this type of court successful as we tailor it to the specific needs of the Tulalip community.”

Another reason that clients are remaining clean and sober throughout and following their journey with the Healing to Wellness Court program can be credited to the Tulalip culture. The program requires its clients to fulfill ‘give-back’ hours to the community. During those volunteer hours, clients not only occupy their time and keep their hands busy during fun, healthy community events, they also begin the process of reintegrating back into the tribal community by participating in cultural practices such as singing, dancing, and learning more of their ancestral lifeways. 

Alicia agrees that the cultural aspect is one of the major contributors to the success of Healing to Wellness Court clients, which is why the tribal courthouse elected to include community and cultural involvement in the new Family Wellness Court program, providing good medicine while encouraging their clients to drop the bad drugs.  

With the establishment of the Family Wellness Court, the Tulalip Justice System continues to combat the drug epidemic on the reservation. The tribal court recently launched the ODMAP program which tracks overdoses that occur on Tulalip territory to help prevent and reduce the loss of lives due to overdose in the community. 

Family Wellness Court intends on officially beginning operations, offering their services to the community, by mid-January 2021. To qualify for the Family Wellness Court’s services, you must be the parent of a Tulalip tribal member who currently has an open child dependency case with the Tribal Court System. Please contact your attorney, beda?chelh social worker or call (360) 716-4764 if you believe the Family Wellness Court can benefit you and your family. 

  “The Family Wellness Court is a model of a community involvement approach. We hope that the community will begin to see the courts as a healing institution; one that can provide solutions for the communities’ various needs,” expressed Chief Judge Demmert. “The Family Wellness Court is another example of how the tribal justice system is evolving to address the needs of the community in a culturally competent manner. We all need to recognize that we have the knowledge of our ancestors standing with us and at times, holding us up.” 

Tulalip Tribal Court introduces ODMAP to combat drug overdose rates in the community

By Kalvin Valdillez, Tulalip News

“There are a lot of overdoses during bonus and Christmas time,” said ODMAP (Overdose Detection Mapping & Application Program) Outreach Specialist, Tashena Hill. “People are feeling sad because they can’t be with their families or they are reminded of family members who passed on. ODs really spike during this time of year, so it is very important for us to get this information out.”

As overdose rates continue to climb nationwide, the Tulalip Tribal Court is taking action in an attempt to address the opioid epidemic on the reservation. Multiple studies from the likes of the CDC and the Washington Post report that Indian Country has been hit the hardest, claiming that from 2006-2014 Natives were 50% more likely to die from an opioid overdose than any other race in the country. Those reputable sources also released a disclaimer stating those statistics are more than likely under reported due to a number of factors. Most misreporting stems from hospitals and coroners indicating the incorrect race on the death certificates of overdose victims. 

The numbers reported on a national level are still staggering. After approximately 70,000 overdose related deaths occurred in 2017, the United States saw that number decrease to 67,000 in 2018. Unfortunately, in 2019, the CDC reports that the drug overdose rate rose by 4.6% in the course of a year to nearly 71,000 deaths nationwide. Early projections indicate that those numbers may have spiked yet again in 2020, citing the novel coronavirus as a key contributor to several overdoses throughout the year. 

In 2017, roughly 30% of deaths in Washington State were attributed to overdose with a large percentage occurring in Snohomish county, particularly the Marysville, Everett and Tulalip region. It would be extremely challenging, however, if you wanted to gather and analyze data regarding the number of overdoses and overdose related deaths at Tulalip alone, as reportings tend to vary based on jurisdictions and which emergency response team answers the call of distress. 

Tulalip Tribal Court Director Alicia Horne explained, “Right now, Tulalip has no central data to utilize to determine OD. This new program is going to create the database to track those statistics, that’s one of the objectives of this program. And prevention. If an emergency response team is responding to a 9-1-1 call and they issue Narcan, having that information will help this program go out to do intervention services and provide detoxing treatments, getting them set-up on a Suboxone or Methadone program. This will help us collect data to see what the overdose rate is in the Tulalip community and how we can provide prevention and intervention services.”

ODMAP, or the Overdose Detection Mapping & Application Program, is a service utilized by communities across the nation. Counties that have elected to use the company’s database have been able to significantly reduce the number of overdoses in their region.

“ODMAP is a system that emergency response personnel like the fire department, EMTs, and the police department can enter real-time data regarding an overdose,” said ODMAP Project Coordinator, Kali Joseph. “That includes a general location of the overdose, whether Naloxone was administered, how much Naloxone was administered, and whether the overdose was fatal or not. And then we have our outreach workers deploy the resources to those people who are susceptible to overdose or are suffering with substance abuse disorder.”

Having access to those reports is a major step in addressing the opioid and heroin epidemic on the reservation. Now TPD and other emergency response teams can pinpoint specific neighborhoods and areas that are affected most by drug overdose and can thereby, in theory, disrupt any activity when the numbers are on the rise. 

“Using the ODMAP app we can see a spike happen in real-time,” expressed ODMAP Social Worker, Cara McCoy. “When we have all these spikes and overdoses, we can warn the community that maybe there’s a bad drug and to be careful. The app is really easy to use so the officer or whoever has the app will be able to capture it immediately so we have more accurate numbers.”

In addition to tracking and monitoring overdoses on the reservation, the ODMAP team is focused on promoting a healthy Tulalip community and will provide outreach work, cultural activities, and endless resources for those ready and willing to leave their addiction in the past. 

“We’re working on getting a list of all the things that could be barriers in between someone obtaining their sobriety,” stated Kali. “That could be food, a driving abstract, Washington State ID, duffle bag, clothes, signing up for insurance, cell phones, or providing them with a ride. Sometimes the fees for a driving abstract or an ID, to be able to get into a detox center or treatment, can be a very big barrier for people trying to get clean and sober so we just want be able to help them break down those barriers.”

Added Tashena, “The biggest obstacle for any of our clients is having a place to go after coming home from treatment or jail. The Tribe doesn’t offer anything for short-term, so we’re working on trying to find a place for them to go in the interim. We need somewhere for them to go so they can be successful on their journey.”

The very first project for the ODMAP team is taking place on December 16, a virtual training session that will inform those who attend how to appropriately and effectively administer Naloxone or Narcan nasal spray, which can potentially save someone’s life in the event of an overdose. According to their research, 690 overdoses in Washington State were reversed with Naloxone in 2016.

“It first started with Cara setting up a meeting with the Swinomish Wellness Center, they have reduced their overdose rate by 50%,” Kali noted. “We asked them what type of things they’re doing to reduce their rate so greatly and they said that a big factor was distributing Narcan to the community members. We thought we should have a Narcan distribution for our community right before the holidays. It was actually Tashena’s idea to do it before the holidays, especially because we all get this big chunk of money. We are here for prevention and we think that sharing information and knowledge is a really good prevention method, as well as distributing the Narcan.”

In total, the ODMAP team will distribute 50 Narcan kits to the community by December 18. Those who wish to receive a kit will be required to sign-up and attend a GoToMeeting session on Wednesday December 16. The trainings will be split into two sessions, one at 10:00 a.m. and the other at 2:00 p.m., and will be limited to 25 participants per session. After attending the training, the ODMAP team will hand-deliver the Narcan kits to your doorstep, along with other resources, including information about the program as well as some fun holiday gifts. You must be at least 13 years old to attend the training and receive a Narcan kit. 

“Our team is driven to reduce the overdose rates here at Tulalip,” expressed Tashena. “This is important to me as a Tribal member who has suffered from this opioid affliction, being able to give back to my people and show them there is hope. If I can overcome such a horrendous obstacle then anyone can. There is help here for people that want it or need it. There are people who care and are more than willing to help our community members if they want it. The upcoming Narcan training is so important because if we can save anyone, even one person, that is a win. Every last person matters. That is our way, huyadad, to care for every one of our members. At least that’s what my grandfather Stan Jones Sr. taught me – to care for everyone.”

For further information and to register for the upcoming Narcan presentation and distribution, please contact Tashena Hill at (360)-913-7897 or, Melissa Gover at (360)-631-2668 or, or Cara McCoy at (360)-631-7443 or

beda?chelh program designed to FIT your family’s needs

By Kalvin Valdillez, Tulalip News

Did you know that there is a program that helps with resources, education, and general support designed specifically for Tulalip tribal families living with children?  If not, you’re not alone as the program is still relatively new. A division of beda?chelh, the young program is spreading the word about their services and what they can offer Tribal families. 

Stated beda?chelh manager, Natasha Fryberg, “I want to bring forth our FIT team to start getting more resources out in the community so we can create positive engagement with potential clients and families.”

The Family Intervention Team, or FIT, currently consists of two social workers, Lena Hoeflich and Kayleigh Canby, who are dedicated to aiding Tulalip families by helping them along their journey through tough times. Whether you are a single pregnant mother or a family dealing with a rebellious teen, they are available and ready to help support you and provide any services or needs you may require. 

“I always describe it to clients as a voluntary program,” said Kayleigh. “Our goal is to kind of bolster the family, or bring in supports, to help them be successful in whatever they want to do. Usually, the goal is to try and keep their families together and we bring in those supports to help them be successful. We support parents, we support children, we support everybody.”

The FIT mission is to achieve immediate and lasting positive change for families, in the best interest of the children, whether you live on or off the reservation. FIT makes it their priority to see that you receive assistance and will refer you to a program, professional or specialist who will provide you with further care. 

Lena explains, “We try to bridge a gap that a family might be experiencing, a hardship – whatever that may be. We meet with families and it is family-led. It’s not prescriptive, because it just depends on whatever the family needs, and whatever they’re going through at that time. For example, if someone calls and says this person was driving and their kid wasn’t in a car seat, we can come in and ask if we can educate them on the necessity of a car seat. Can we provide them with a car seat? We can ask, what else do they need? Do they need groceries? Do they need help paying bills? Do their kids need assistance being set up in online schooling?”

Some resources and services that FIT assists families with include parenting skills, housing, food and nutrition, domestic violence, independent living skills, chemical dependency, teen support and mental health. 

“If a family is experiencing a really difficult time with their teenager, we work with them and get them set-up with Family Haven. We will work with them before, during, and after they have those intervention services, just to make sure that everything is continuing to go well. Or we might work with families who may have difficulty paying a bill. We look to see if there are resources within the Tribe or within the state or Snohomish County, just to try to find different ways to help,” said Lena.

Kayleigh added, “I have a mom that I’m working with right now and I’m trying to help her find a mental health counselor. At the same time, I reached out to a couple different agencies locally, she’s a pregnant mom, so she needs a bed to sleep on. We do the legwork of trying to find those materials. I have another family and their children are in need of winter clothes, so we find those resources in the community to get warm clothes for those kids.”

The majority of clients and families that FIT has helped so far are referrals from Child Protective Services. However, FIT wishes to assure Tribal members that they are here for the people, and welcome any community-referred and self-referred clients. Although they are an extension of beda?chelh, their focus is to work with clients and take preventive measures and progressive steps to help keep families together. 

“A lot of families have a huge support network, but there are other individuals who don’t have any support networks at all,” Kayleigh expressed. “We’re here to help support them, we are apart from CPS. We are a voluntary program, we’re not going to hunt you down or tell you what to do. I think that’s the biggest message is that we’re just here to help, we’re here to raise-up the community in the ways that they want.”

Lena agreed, saying, “I think that’s a distinction that we’re trying hard to make people understand, because when we do call and say we’re a new program with beda?chelh, that usually closes the door immediately. We’re very different. The whole point of our program is to prevent families from having interventions or any interaction, really, with CPS or the court systems. We’ll work with any family who we think would be a good ‘fit’ in the program.”

For additional information about the Family Intervention Team, please contact (360) 716-3284.